Burden of liver disease in Brazil, 1996-2022: a retrospective descriptive study of the epidemiology and impact on public healthcare.

Background: Liver disease is a major cause of mortality and morbidity worldwide and its epidemiology depends on the genetic background, exposure to risk factors, access to healthcare and other sociodemographic characteristics. Brazil is a large country with diverse multicultural and ethnic heritages and important socioeconomic inequalities. The burden of liver disease in Brazil, its regions and population is unknown. Methods: We retrieved data from the Unified Health System regarding liver diseases and analyzed the mortality and morbidity from 1996 to 2022 by gender, race/ethnicity, age, region and overall. We calculated the age-specific risk of deaths by liver disease, age-standardization of the data, mean hospitalization and liver transplant-associated costs. Findings: Malignant neoplasm of the liver and intrahepatic bile ducts, alcohol-associated liver disease, fibrosis, and cirrhosis of the liver, other diseases of the liver, hepatic failure, chronic viral hepatitis were identified as the major causes of death and morbidity in Brazil in the period analyzed. The epidemiology of these diseases was diverse, with variations according to geographic regions, gender and race/ethnicity. The major economic burden of liver disease is related to liver transplants, a common outcome of the progression of these diseases. Interpretation: Liver disease in Brazil is a serious issue for the public health system due to the high number of deaths and increasing mortality rate. Our study contributes as a necessary prerequisite for the development of tailored public health policies aimed at mitigating the increasing burden of liver diseases in specific populations and regions. Funding: CNPq, INCT, CAPES, FAPEMIG.

Severe Covid-19 in pregnant and postpartum women admitted to an intensive care unit: A retrospective cohort study.

BACKGROUND: SARS-CoV-2 infection is associated with worse maternal and fetal outcomes. This study aims to describe the characteristics of pregnant and postpartum women with severe Covid-19 admitted to ICU. METHODS AND FINDINGS: It's a retrospective cohort study evaluating pregnant and postpartum women referenced to a specialized ICU between May 2020 and June 2022. Covid-19 was confirmed with RT-PCR or rapid antigen test on a nasopharyngeal swab. Variables were described by median and IQR when numerical, and by frequency and percentage when categorical. OR with 95% CI were calculated for the evaluation of factors related to death. P-values were calculated using Pearson's ꭓ2-test, Fisher's exact test, Wilcoxon rank sum test, and Kruskall-Wallis test, and statistical significance was established as < 0·05. Missing data were excluded. All statistical analysis were performed using R software version 4.2.2. Of the 101 admissions, 85 (84·2%) were of pregnant women. Obesity (23·0%) and systemic arterial hypertension (13·0%) were the most prevalent medical conditions. Sixty-six (65·3%) were admitted using some type of oxygen support. Forty-seven (46·5%) evolved to mechanical ventilation. There were 61 events considered obstetric complications, with 8 stillbirths/fetal losses. The overall lethality was 15·8%. Pregnancy interruption, need for non-invasive mechanical ventilation, level of oxygen support at admission, prone maneuver, hemodialysis, and healthcare-related infections were factors associated with death. Evaluating the WHO 7-category ordinary scale, there was a trend of increase in the risk of death with higher punctuation, with a statistically significant difference of women with 5 (OR = 7·27; 95% IC = 1·17-194; p = 0·031) or 6 points (OR = 12·0; 95% IC = 1·15-391; p = 0·038) when compared to the ones with 3 points, i.e., of women admitted with a high-flow non-rebreathing mask or invasive mechanical ventilation, compared with the ones admitted at room air, respectively. The main limitations of this study are the relatively small number of participants, and the use of data derived of medical records-which are susceptible to misclassification and variable amounts of missing data. CONCLUSIONS: Pregnant and postpartum women with severe Covid-19 have high lethality and a high incidence of clinical and obstetric complications. These findings support that this population should be prioritized in public health strategies that address Covid-19.

Dry reforming of methane over gallium-based supported catalytically active liquid metal solutions.

Gallium-rich supported catalytically active liquid metal solutions (SCALMS) were recently introduced as a new way towards heterogeneous single atom catalysis. SCALMS were demonstrated to exhibit a certain resistance against coking during the dehydrogenation of alkanes using Ga-rich alloys of noble metals. Here, the conceptual catalytic application of SCALMS in dry reforming of methane (DRM) is tested with non-noble metal (Co, Cu, Fe, Ni) atoms in the gallium-rich liquid alloy. This study introduces SCALMS to high-temperature applications and an oxidative reaction environment. Most catalysts were shown to undergo severe oxidation during DRM, while Ga-Ni SCALMS retained a certain level of activity. This observation is explained by a kinetically controlled redox process, namely oxidation to gallium oxide species and re-reduction via H2 activation over Ni. Consequentially, this redox process can be shifted to the metallic side when using increasing concentrations of Ni in Ga, which strongly suppresses coke formation. Density-functional theory (DFT) based ab initio molecular dynamics (AIMD) simulations were performed to confirm the increased availability of Ni at the liquid alloy-gas interface. However, leaching of gallium via the formation of volatile oxidic species during the hypothesised redox cycles was identified indicating a critical instability of Ga-Ni SCALMS for prolonged test durations.

Usefulness of machine learning softwares to screen titles of systematic reviews: a methodological study.

OBJECTIVE: To investigate the usefulness and performance metrics of three freely-available softwares (Rayyan®, Abstrackr® and Colandr®) for title screening in systematic reviews. STUDY DESIGN AND SETTING: In this methodological study, the usefulness of softwares to screen titles in systematic reviews was investigated by the comparison between the number of titles identified by software-assisted screening and those by manual screening using a previously published systematic review. To test the performance metrics, sensitivity, specificity, false negative rate, proportion missed, workload and timing savings were calculated. A purposely built survey was used to evaluate the rater's experiences regarding the softwares' performances. RESULTS: Rayyan® was the most sensitive software and raters correctly identified 78% of the true positives. All three softwares were specific and raters correctly identified 99% of the true negatives. They also had similar values for precision, proportion missed, workload and timing savings. Rayyan®, Abstrackr® and Colandr® had 21%, 39% and 34% of false negatives rates, respectively. Rayyan presented the best performance (35/40) according to the raters. CONCLUSION: Rayyan®, Abstrackr® and Colandr® are useful tools and provided good metric performance results for systematic title screening. Rayyan® appears to be the best ranked on the quantitative and on the raters' perspective evaluation. The most important finding of this study is that the use of software to screen titles does not remove any title that would meet the inclusion criteria for the final review, being valuable resources to facilitate the screening process.

Deepening and widening the gap: The impacts of the COVID-19 pandemic on gender and racial inequalities in Brazil.

Shaped by inconsistent policy decisions, the COVID-19 pandemic in Brazil has made structural gender and racial inequalities more acute. Black and low-income women are overburdened with unpaid domestic work, increased domestic violence, and more vulnerable due to informal and exploitative working regimes. These structural aspects are intensifying, since the pandemic has broadened inequalities at the intersection of gender, race, labor market, and social class. We examine pre- and during pandemic inequalities on three dimensions: (a) unpaid domestic and care work, (b) women's labor market participation, and (c) domestic violence. We link the care diamond model and racial stratification forwarding a feminist perspective by examining how the interlocking of race and gender in Brazil renders different socioeconomic dynamics to the detriment of Black and low-income women. Based on this evidence, we stress that a more equal future requires a better social protection and policies targeting the articulation of gender, race, and class.

Gendering the crisis: austerity and the Covid-19 pandemic in Brazil.

In this article, by showing that the burden of retrenchment in social spending in Brazil has been overwhelmingly borne by women, we assert that austerity is not gender neutral. Our research investigates the specificities of the gendered impacts of austerity in the country that have rendered Brazilian women structurally more vulnerable to the Covid-19 crisis. We base our argument on a comprehensive literature review summarizing the links between austerity and gender. In the Brazilian case, we explain women's vulnerability in two main aspects: (1) the direct and indirect gendered impacts of austerity in Brazil since 2015, examining the underfunding of policies prior to the pandemic; (2) the gendered effects of the pandemic on already vulnerable groups, amplified by the underfunded policies and the lack of appropriate measures. We show points of proximity between the existing literature on austerity and gender in the Global North and the urgent, structural Brazilian problems.

Percepções e experiências de mulheres atuantes no campo da saúde sobre violências de gênero / Perceptions and experiences of women active in the health field on gender violence

RESUMO Este artigo é fruto de uma pesquisa de mestrado que se propôs a mapear e analisar as percepções de mulheres que atuam no campo da saúde coletiva brasileira sobre violências de gênero vividas e expressas em seus cotidianos, a partir do recorte de um estudo amplo, intitulado 'Mulheres da Saúde Coletiva: um retrato de quem constrói o campo', desenvolvido pelo movimento de pesquisa-intervenção-luta de mulheres atuantes nesse campo, que formam a 'Coletiva Adelaides: Feminismos e Saúde'. Trata-se de um estudo quanti-qualitativo, do tipo pesquisa-intervenção, que parte do método da cartografia e dos referenciais teóricos das epistemologias feministas negras. Os resultados são apresentados com base na tipificação das violências percebidas pelas mulheres, na sua interface com o processo do trabalho em saúde e na cotidianidade, apontando para a persistência e a gravidade das violências identificadas no cotidiano de mulheres atuantes no campo da saúde coletiva e nas contribuições possíveis para os estudos de gênero, que se dão pelo aprofundamento e pela análise desse cenário a partir da articulação dos conceitos de interseccionalidade e política do empoderamento, bem como pelo delineamento de possibilidades para enfrentamento dessas violências.

ABSTRACT This article is the result of a master's research that aimed to map and analyze the perceptions of women who work in the field of Brazilian public health on gender violence experienced and expressed in their daily lives, through the cut-out of a broad study, entitled 'Women of Collective Health: a portrait of who builds the field', developed by the research-intervention-struggle movement of women active in this field, who form the 'Collective Adelaides: Feminisms and Health'. This is a quanti-qualitative study, intervention-type research, which starts from the mapping method and the theoretical references of black feminist epistemologies. The results are presented based on the typification of violence perceived by women, their interface with the process of work in health and daily life, pointing to the persistence and severity of the violence identified in the daily life of women working in the field of collective health and the possible contributions to gender studies, which are given by the deepening and analysis of this scenario from the articulation of the concepts of intersectionality and empowerment policy, as well as the delineation of possibilities for coping with these violence.

Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight

ABSTRACT BACKGROUND: Multiple opinion-based communications have highlighted the actions of the Brazilian government during the pandemic. Nevertheless, none have appraised public data to identify factors associated with worsening of the healthcare system. OBJECTIVE: To analyze and collate data from public health and treasury information systems in order to understand the escalating process of weakening of Brazilian healthcare and welfare since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. DESIGN AND SETTING: Secondary data study conducted using multiple public databases administered by the Brazilian federal government. METHODS: We processed information from multiple national databases and appraised health and economic-related data. RESULTS: Based on our analyses, there were substantial reductions in inpatient hospital admissions and in the numbers of patients seeking primary care services, along with a decrease in immunization coverage. Moreover, we observed a considerable decline in government transfers to hospital services (reduction of 82.0%) and a diminution of public outlays in several healthcare-related subfunctions ("hospital and outpatient care", "primary care", "prophylactic and therapeutic support" and "epidemiological surveillance"). We observed an increase in the overall mortality rate over the period analyzed, especially regarding all group-based diseases. Notably, there were remarkable differences among geographic, racial, gender and other parameters, thus revealing the impact of vulnerabilities on COVID-19 outcomes. CONCLUSION: This assessment of documentation of public expenditure and the shrinkage of investment in sensitive areas of the healthcare system in Brazil emphasized areas that still require collective attention in order to guarantee national welfare.

Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight.

BACKGROUND: Multiple opinion-based communications have highlighted the actions of the Brazilian government during the pandemic. Nevertheless, none have appraised public data to identify factors associated with worsening of the healthcare system. OBJECTIVE: To analyze and collate data from public health and treasury information systems in order to understand the escalating process of weakening of Brazilian healthcare and welfare since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. DESIGN AND SETTING: Secondary data study conducted using multiple public databases administered by the Brazilian federal government. METHODS: We processed information from multiple national databases and appraised health and economic-related data. RESULTS: Based on our analyses, there were substantial reductions in inpatient hospital admissions and in the numbers of patients seeking primary care services, along with a decrease in immunization coverage. Moreover, we observed a considerable decline in government transfers to hospital services (reduction of 82.0%) and a diminution of public outlays in several healthcare-related subfunctions ("hospital and outpatient care", "primary care", "prophylactic and therapeutic support" and "epidemiological surveillance"). We observed an increase in the overall mortality rate over the period analyzed, especially regarding all group-based diseases. Notably, there were remarkable differences among geographic, racial, gender and other parameters, thus revealing the impact of vulnerabilities on COVID-19 outcomes. CONCLUSION: This assessment of documentation of public expenditure and the shrinkage of investment in sensitive areas of the healthcare system in Brazil emphasized areas that still require collective attention in order to guarantee national welfare.

Care for the spiritual dimension provided by caregivers in a nursing home / Atención a la dimensión espiritual proporcionada por los cuidadores en un hogar para ancianos / Cuidado à dimensão espiritual prestado por cuidadores em instituição de longa permanência para idosos

ABSTRACT Objectives: to understand care for the spiritual dimension provided by caregivers in a Nursing Home. Methods: this is a qualitative research, carried out in a geriatric center of a philanthropic hospital in the city of Salvador, Bahia. Eighteen formal caregivers participated, through a semi-structured interview, between January and February 2019. The data were analyzed in the light of Jean Watson's Theory of Transpersonal Caring. Results: formal caregivers discuss the spiritual dimension based on older adults' religious beliefs, encourage religious practices and exercise spiritual care according to older adults' physical, emotional and spiritual demands. Final Considerations: formal caregivers understand that older adults' religious or spiritual experiences should be included in their work routine. Care for the spiritual dimension occurs by stimulating faith in God, encouraging religious practices and embracing their beliefs in the face of physical, emotional and spiritual demands.

RESUMEN Objetivos: aprehender el cuidado de la dimensión espiritual que brindan los cuidadores en un centro de cuidados de larga duración para personas mayores. Métodos: investigación cualitativa, realizada en un centro geriátrico de un hospital filantrópico de la ciudad de Salvador, Bahía. Dieciocho cuidadores formales participaron, a través de la entrevista semiestructurada, entre enero y febrero de 2019. Los datos fueron analizados a la luz de la Teoría del Cuidado Transpersonal de Jean Watson. Resultados: el cuidador formal dialoga sobre la dimensión espiritual a partir de las creencias religiosas del anciano, incentiva las prácticas religiosas y ejerce el cuidado espiritual de acuerdo con las demandas físicas, emocionales y espirituales del anciano. Consideraciones Finales: los cuidadores formales entienden que las experiencias religiosas o espirituales del anciano deben incluirse en su rutina laboral. El cuidado de la dimensión espiritual ocurre estimulando la fe en Dios, fomentando las prácticas religiosas y abrazando sus creencias frente a las demandas físicas, emocionales y espirituales.

RESUMO Objetivos: apreender o cuidado à dimensão espiritualprestado porcuidadoresem instituição de longa permanência para idosos. Métodos: pesquisa qualitativa, realizada em um centro geriátrico de hospital filantrópico na cidade de Salvador, Bahia. Participaram 18 cuidadores formais, por meio da entrevista semiestruturada, entre janeiro e fevereiro de 2019. Os dados foram analisados à luz da Teoria do Cuidado Transpessoal de Jean Watson. Resultados: o cuidador formal dialoga sobre a dimensão espiritual a partir das crenças religiosas do idoso, incentiva as práticas religiosas e exerce o cuidado espiritual de acordo com as demandas físicas, emocionais e espirituais da pessoa idosa. Considerações Finais: os cuidadores formais compreendem que as vivências religiosas ou espirituais da pessoa idosa devem ser incluídas na sua rotina de trabalho. O cuidado à dimensão espiritual ocorre pelo estímulo a fé em Deus, incentivo às práticas religiosas e acolhimento de suas crenças frente às demandas físicas, emocionais e espirituais.

Ga-Ni supported catalytically active liquid metal solutions (SCALMS) for selective ethylene oligomerization.

Non-precious metal supported catalytically active liquid metal solutions exhibit attractive performance in ethylene oligomerization. It is found for the Ga-Ni system on silica that the performance depends strongly on the applied Ga/Ni ratio. Ga-rich systems forming liquid alloys exhibit a far higher Ni-based catalytic activity than solid intermetallic compounds or Ni nanoparticles.

Health workers' perspectives on asthma care coordination between primary and specialised healthcare in the COVID-19 pandemic: a protocol for a qualitative study in Ecuador and Brazil.

INTRODUCTION: Asthma is a common long-term disorder and strategies to improve asthma control are still a challenge. Integrated delivery of health systems is critical for effective asthma care: there is limited information on experiences of care coordination for asthma from Latin America, especially on perspectives of health personnel and in the context of the COVID-19 pandemic. METHODS AND ANALYSIS: This protocol details a qualitative approach to analyse health workers' perspectives of healthcare coordination for asthma control during COVID-19 pandemic in Ecuador and Brazil, at primary and specialised levels, through in-depth semistructured interviews using a video communications platform. The analysis will identify knowledge and perspectives based on coordination of clinical information, clinical management and administrative coordination. Theoretical sampling will be used to obtain approximately equal numbers of women and men within each level of healthcare; data saturation will be used to determine sample size. Transcripts will be analysed using content-coding procedures to mark quotations related to major topics and subthemes included in the interview guide, and narrative analysis will be based on a theoretical framework for healthcare coordination to identify new themes and subthemes. ETHICS AND DISSEMINATION: Ethical approval was obtained from the ethics committees of Hospital General Docente Calderón, Quito, Ecuador; and Universidade Federal da Bahia, Salvador, Brazil. The findings of this study will be disseminated through peer-reviewed articles, conference presentations and condensed summaries for key stakeholders and partners.

Care for the spiritual dimension provided by caregivers in a nursing home.

OBJECTIVES: to understand care for the spiritual dimension provided by caregivers in a Nursing Home. METHODS: this is a qualitative research, carried out in a geriatric center of a philanthropic hospital in the city of Salvador, Bahia. Eighteen formal caregivers participated, through a semi-structured interview, between January and February 2019. The data were analyzed in the light of Jean Watson's Theory of Transpersonal Caring. RESULTS: formal caregivers discuss the spiritual dimension based on older adults' religious beliefs, encourage religious practices and exercise spiritual care according to older adults' physical, emotional and spiritual demands. FINAL CONSIDERATIONS: formal caregivers understand that older adults' religious or spiritual experiences should be included in their work routine. Care for the spiritual dimension occurs by stimulating faith in God, encouraging religious practices and embracing their beliefs in the face of physical, emotional and spiritual demands.

Nanocarriers as a Tool for the Treatment of Colorectal Cancer.

Nanotechnology is a promising tool for the treatment of cancer. In the past decades, major steps have been made to bring nanotechnology into the clinic in the form of nanoparticle-based drug delivery systems. The great hope of drug delivery systems is to reduce the side effects of chemotherapeutics while simultaneously increasing the efficiency of the therapy. An increased treatment efficiency would greatly benefit the quality of life as well as the life expectancy of cancer patients. However, besides its many advantages, nanomedicines have to face several challenges and hurdles before they can be used for the effective treatment of tumors. Here, we give an overview of the hallmarks of cancer, especially colorectal cancer, and discuss biological barriers as well as how drug delivery systems can be utilized for the effective treatment of tumors and metastases.

Vivência integrada na comunidade: experiências de uma escola médica durante a pandemia da Covid-19 / Community-integrated living: experiences of a medical school during the Covid-19 pandemic

Este livro traz em cada página trajetórias de muitos sujeitos de transformação de mundo que (r)existem no Sertão Potiguar. São flores de mandacaru que floresceram na pandemia, reafirmando a importância de uma universidade pública socialmente referenciada e comprometida com a realidade local na qual se insere. "Cumpre seu propósito especial de retratar as ações da Escola Multicampi de Ciências Médicas, instituição de ensino superior inserida no interior do nordeste brasileiro e que, diante do grave cenário que enfrentamos, exerce seu papel social por meio de ações orquestradas e pensadas em distintas frentes de trabalho. Os relatos e análises dispostos nesta obra são fruto do trabalho de estudantes, professores, servidores e trabalhadores de saúde genuinamente inquietos, curiosos e dispostos a colaborar com as diversas necessidades de saúde surgidas ou intensificadas pela pandemia da Covid-19." Diego Bonfada, docente que compõe a organização do livro.

Intravenous magnesium sulfate for postoperative analgesia after abdominal hysterectomy under spinal anesthesia: a randomized, double-blind trial.

BACKGROUND AND OBJECTIVES: Abdominal Hysterectomy (AH) is associated with significant inflammatory response and can result in moderate to severe postoperative pain. This study aimed to evaluate the efficacy of magnesium infusion in reducing postoperative pain and analgesic consumption after AH under spinal anesthesia with Intrathecal Morphine (ITM). METHOD: Eighty-six patients were included in this clinical, controlled, randomized, double-blind study. Patients received in Group Mg, MgSO4 50mgkg-1 for 15 minutes followed by 15 mgkg-1h-1 until the end of the surgery; and in Group C, (control) the same volume of isotonic saline. Both groups received 100µg of ITM. All patients received dipyrone+ketoprofen intraoperatively and postoperatively, and dexamethasone intraoperatively only. We evaluated the intensity of pain, tramadol consumption, and adverse events 24hours postoperatively. RESULTS: Serum magnesium concentrations were higher in Group Mg at the end, and one hour after the operation (p=0.000). Postoperative pain scores were reduced in Group Mg at 6 hours at rest and on movement (p<0.05). Tramadol consumption did not show a statistically significant difference between Group Mg and Group C (15.5±36.6mg and 29.2±67.8mg respectively, p=0.53). Hemodynamic variables, the incidence of pruritus, nausea, and vomiting were similar in the two groups. CONCLUSION: Infusion of MgSO4 during AH undergoing spinal anesthesia with ITM reduced at 6 hours at rest and on movement. More studies should be performed to evaluate the potential antinociceptive effect of MgSO4 in scenarios where a multimodal analgesia approach was employed.

Maximizing the potency of oxaliplatin coated nanoparticles with folic acid for modulating tumor progression in colorectal cancer.

One of the challenges of nanotechnology is to improve the efficacy of treatments for diseases, in order to reduce morbidity and mortality rates. Following this line of study, we made a nanoparticle formulation with a small size, uniform surfaces, and a satisfactory encapsulation coefficient as a target for colorectal cancer cells. The results of binding and uptake prove that using the target system with folic acid works: Using this system, cytotoxicity and cell death are increased when compared to using free oxaliplatin. The data show that the system maximized the efficiency of oxaliplatin in modulating tumor progression, increasing apoptosis and decreasing resistance to the drug. Thus, for the first time, our findings suggest that PLGA-PEG-FA increases the antitumor effectiveness of oxaliplatin by functioning as a facilitator of drug delivery in colorectal cancer.

Elderly people's experiences in emergencies through access to other levels of health care.

OBJECTIVE: to understand elderly people's experiences in emergencies through access to other levels of health care. METHODS: a phenomenological study in the light of Heidegger, conducted with 19 elderly patients admitted to an Emergency Care Unit of the city of Salvador, between April and October 2019. RESULTS: ontic primacy: Disposition of the experience of elderly people waiting for regulation; Constitutional anguish and fear in the willingness to be an elderly person waiting for regulation in an Emergency Care Unit; Inappropriate elderly being suppressed while waiting for regulation; Being an elderly person unveiled in the existential modality of being for death. Ontological primacy: Heal how to be the presence of elderly people waiting for regulation. FINAL CONSIDERATIONS: elderly people being anguished and afraid, feelings that allow the questioning of their own being, who want a healing and seeks ways that allows an active and proper participation in care.

As oficinas terapêuticas e a lógica do cuidado psicossocial: concepções dos(as) coordenadores(as) / Therapeutic workshops and the logic of psychosocial care: conceptions of coordinators / Los talleres terapéuticos y la lógica del cuidado psicosocial: concepciones de los/as coordinadores/as

Como reflexo da reconfiguração da assistência em saúde mental proporcionada pela Reforma Psiquiátrica Brasileira, as oficinas terapêuticas vieram a se tornar, gradativamente, um dos principais dispositivos de tratamento nos Centros de Atenção Psicossocial (Caps). Porém, poucos estudos dedicados ao assunto elegeram como participantes profissionais de saúde responsáveis por oficinas terapêuticas. O presente estudo teve como objetivo compreender as concepções de um grupo de profissionais de saúde que coordenavam oficinas terapêuticas em Caps a respeito de tal prática. Trata-se de um estudo clínico-qualitativo, do qual participaram 12 profissionais de saúde que conduziam - à época da coleta de dados - oficinas terapêuticas em Caps de uma cidade do interior de Minas Gerais. A coleta de dados envolveu o recurso a uma entrevista semiestruturada e a um diário de campo. A análise de conteúdo foi a técnica aplicada ao corpus e levou à organização dos resultados em um conjunto de categorias e subcategorias. Nesta oportunidade, foram contempladas duas subcategorias, que abarcaram concepções sobre os objetivos e as especificidades das oficinas terapêuticas, e uma categoria, a qual tratou das concepções sobre a (não) adesão à referida prática. Em linhas gerais, os resultados revelam tanto aproximações quanto distanciamentos entre as concepções das participantes e a lógica do cuidado psicossocial preconizada pela Reforma Psiquiátrica Brasileira. Logo, o presente estudo reforça a necessidade de se fazer das oficinas terapêuticas objeto de reflexão permanente para que tal dispositivo de tratamento não venha a ser desfigurado.(AU)

As a result of the mental healthcare reconfiguration prompted by the Brazilian Psychiatric Reform, therapeutic workshops gradually became one of the main treatment strategies in Psychosocial Care Centers (CAPS). However, few studies on the theme include health professionals responsible for therapeutic workshops as participants. This study aimed to understand the conceptions of 12 health professionals who were responsible for therapeutic workshops in CAPS regarding this practice. This is a clinical-qualitative study, in which participated 12 health professionals who were responsible - at the time of the data collection - for therapeutic workshops at Caps in a countryside city in Minas Gerais (Brazil). Data were collected using a semi-structured interview and a field diary. The resulting corpus underwent content analysis, being organized into a set of categories and subcategories. This study covered two subcategories addressing conceptions on therapeutic workshops objectives and particularities, and one category addressing conceptions related to (non-)adherence to this practice. The results reveal both approximations and gaps between participants' conceptions and the logic of psychosocial care recommended in the Brazilian Psychiatric Reform. Hence, this study reinforces the need for making therapeutic workshops an object of continuous reflection to avoid the disfigurement of this treatment.(AU)

La reconfiguración de la atención en salud mental, mediante la Reforma Psiquiátrica Brasileña, posibilitó que los talleres terapéuticos se volviesen gradualmente uno de los principales dispositivos de tratamiento en los Centros de Atención Psicosocial (Caps). Pero son pocos estudios dedicados al tema que eligieron como participantes a los profesionales de salud responsables por talleres terapéuticos. Este estudio pretende comprender las concepciones de un grupo de profesionales de salud a cargo de la coordinación de talleres terapéuticos en Caps respecto a tal práctica. Este es un estudio clínico-cualitativo, en el cual participaron 12 profesionales de salud que ministraban - en el periodo de la recopilación de datos - talleres terapéuticos en Caps de una ciudad de Minas Gerais (Brasil). Para recopilar los datos se utilizó una entrevista semiestructurada y un diario de campo. El análisis de contenido fue la técnica aplicada al corpus y organizó los resultados en un conjunto de categorías y subcategorías. Dos subcategorías abarcaron concepciones sobre los objetivos y las especificidades de los talleres terapéuticos, y una categoría trató de las concepciones sobre la (no)adhesión a esa práctica. Los resultados revelan tanto aproximaciones como alejamientos entre las concepciones de las participantes y la lógica del cuidado psicosocial preconizada por la Reforma Psiquiátrica Brasileña. Por lo tanto, este estudio refuerza que es necesaria una reflexión permanente sobre los talleres terapéuticos para que ese dispositivo de tratamiento no se vea desfigurado.(AU)

Elderly people's experiences in emergencies through access to other levels of health care / Experimentado por los ancianos en situaciones de emergencia debido al acceso a otros niveles de satención de la salud / Vivido pelo idoso nas emergências pelo acesso para outros níveis de atenção à saúde

ABSTRACT Objective: to understand elderly people's experiences in emergencies through access to other levels of health care. Methods: a phenomenological study in the light of Heidegger, conducted with 19 elderly patients admitted to an Emergency Care Unit of the city of Salvador, between April and October 2019. Results: ontic primacy: Disposition of the experience of elderly people waiting for regulation; Constitutional anguish and fear in the willingness to be an elderly person waiting for regulation in an Emergency Care Unit; Inappropriate elderly being suppressed while waiting for regulation; Being an elderly person unveiled in the existential modality of being for death. Ontological primacy: Heal how to be the presence of elderly people waiting for regulation. Final considerations: elderly people being anguished and afraid, feelings that allow the questioning of their own being, who want a healing and seeks ways that allows an active and proper participation in care.

RESUMEN Objetivo: comprender lo que viven los ancianos en situaciones de emergencia a través del acceso a otros niveles de atención de la salud. Métodos: estudio fenomenológico a la luz de Heidegger, realizado con 19 pacientes ancianos ingresados en la Unidad de Urgencias de la ciudad de Salvador, entre los meses de abril y octubre de 2019. Resultados: primacía óntica: disposición de la experiencia del anciano en espera de regulación; Angustia constitucional y miedo ante la voluntad de ser un anciano en espera de regulación en una unidad de emergencia; Ancianos inapropiados reprimidos mientras esperan la regulación; Ser un anciano desvelado en la modalidad existencial del ser para la muerte. Primacía ontológica: Cura cómo ser la presencia del anciano esperando la regulación. Consideraciones finales: el anciano está angustiado y asustado, sentimientos que permiten el cuestionamiento de su propio ser, que quiere una cura y busca caminos que le permitan una participación activa y adecuada en el cuidado.

RESUMO Objetivo: compreender o vivido pelo idoso nas emergências pelo acesso para outros níveis de atenção à saúde. Métodos: estudo fenomenológico à luz de Heidegger, realizado com 19 idosos internados em Unidade de Pronto Atendimento do município de Salvador, entre os meses de abril e outubro de 2019. Resultados: primado ôntico: Disposição do vivido da pessoa idosa à espera pela regulação; Angústia e medo constitutivos na disposição de ser idoso à espera pela regulação em Unidade de Pronto Atendimento; Ser idoso impróprio suprimido na espera pela regulação; Ser idoso próprio desvelado na modalidade existenciária de ser para a morte. Primado ontológico: Cura como ser da presença da pessoa idosa à espera pela regulação. Considerações finais: o ser idoso se angustia e tem medo, sentimentos que permitem o questionamento do próprio ser, que deseja a cura e busca caminhos que permite uma participação ativa e própria no cuidado.